Prescription drug abuse can be curbed with Canada-wide plan: experts

OTTAWA — Canada now has a national strategy to tackle the escalating prescription drug abuse crisis that has crippled so many families, communities and First Nations.

The Canadian Centre on Substance Abuse, together with a large group of experts and officials, has published a new 10-year plan that would set up a countrywide surveillance system and overhaul legislation so that doctors and pharmacists no longer prescribe painkillers indiscriminately, and addicts are able to get appropriate and timely help.

A new study indicating overdose deaths have risen in close parallel with the country’s soaring consumption of prescription narcotics is more evidence the painkillers have become Canada’s most dangerous drugs after tobacco and alcohol — and need concerted, national action, says a leading addiction researcher.

“We’re giving them to quite a number of people who don’t really need them that urgently,” said Benedikt Fischer of Simon Fraser University. “There is a reason why other, highly developed industrialized nations from the G8 survive and seem to have rather healthy populations — with 25% or 30% of the amount of opioids as we dispense.”

The strategy takes aim at opioids, stimulants and sedatives.

“This strategy addresses prescription drugs that are legal and have therapeutic uses, but also have a high potential for harm,” states the document, entitled “First Do No Harm: Responding to Canada’s Prescription Drug Crisis.”

It urges governments and regulators to set up a pan-Canadian surveillance system that tracks patterns of prescription drug abuse down to the regional level.

It also recommends that the provinces establish prescription monitoring programs within the next two years by engaging with regulators to clamp down on high-risk prescribing and dispensing practices.

“Existing activities to monitor the harms associated with prescription drugs in Canada are fragmented,” the report states.

“The data sources that do exist in Canada, such as coroner reports, poison centre records, [health] data, losses and thefts data, post-market surveillance related to adverse events data, medication incidents and law enforcement records, are not part of any comprehensive national initiative.”

‘Privacy law, which is not harmonized across jurisdictions, is a significant challenge’

But in order for this part of the strategy to work, governments need to review and reconcile the web of laws that affect prescription drugs, the report warns.

“Federal, provincial and territorial privacy law, which is not harmonized across jurisdictions, is a significant challenge not unique to the monitoring and surveillance stream. Legislation limits how and why personal data are collected and stored. Limited understanding of this legislation impacts how these data are used and shared.”

The plan would also see increased resources for policing, so that law enforcement can raise awareness and promote the safe storage of properly used drugs, instead of just dealing with the fallout from abuse.

The strategy also recommends major improvements to the sharing of information about prevention and abuse, as well as better access for addicts to treatment — especially in remote First Nations where some communities have reported that the overwhelming majority of adults are addicted.

Some First Nations have reported success with treatments that incorporate medicine, counselling and traditional healing, but others have complained that the rules surrounding access to medical treatment are too cumbersome for impoverished, remote areas.

Equal access to programs that have been proven effective is important, the strategy stressed.

‘Individual patients and others with lived experience should be included in decision making or on advisory bodies’

“Timely and equitable access to treatment that is holistic, effective and appropriate can be achieved through changes to policy and regulation, funding mechanisms, evidence-informed practice and exchange of new and emerging practices,” the report says.

“Individual patients and others with lived experience should be included in decision making or on advisory bodies to ensure that system changes are accessible, relevant and responsive.”

While data as to the exact extent of prescription drug abuse is spotty, the report makes it clear that the problem is on the rise.

A survey of youth smokers in 2010-11 found that 8.2% of Canadians in grades 6 to 12 reported using prescription and over-the-counter drugs in the previous year to get high.

In Ontario, 18.6% of people seeking addiction treatment in 2010-11 were struggling with prescription drugs, compared with just 10.6% in 2005-2006.